EP1408111B1 - Verfahren und Reagenz zur Behandlung von Krankheiten die von der Konzentration des Rezeptors für den Wachstumsfaktor der vaskulären Endothelzellen verursacht werden - Google Patents
Verfahren und Reagenz zur Behandlung von Krankheiten die von der Konzentration des Rezeptors für den Wachstumsfaktor der vaskulären Endothelzellen verursacht werden Download PDFInfo
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- EP1408111B1 EP1408111B1 EP04000536A EP04000536A EP1408111B1 EP 1408111 B1 EP1408111 B1 EP 1408111B1 EP 04000536 A EP04000536 A EP 04000536A EP 04000536 A EP04000536 A EP 04000536A EP 1408111 B1 EP1408111 B1 EP 1408111B1
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- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
- C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
- C12N15/09—Recombinant DNA-technology
- C12N15/11—DNA or RNA fragments; Modified forms thereof; Non-coding nucleic acids having a biological activity
- C12N15/113—Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing
- C12N15/1138—Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing against receptors or cell surface proteins
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- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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- C12N2310/00—Structure or type of the nucleic acid
- C12N2310/10—Type of nucleic acid
- C12N2310/12—Type of nucleic acid catalytic nucleic acids, e.g. ribozymes
- C12N2310/121—Hammerhead
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- C12N2310/00—Structure or type of the nucleic acid
- C12N2310/10—Type of nucleic acid
- C12N2310/12—Type of nucleic acid catalytic nucleic acids, e.g. ribozymes
- C12N2310/122—Hairpin
Definitions
- This invention relates to methods and reagents for the treatment of diseases or conditions relating to the levels of expression of vascular endothelial growth factor (VEGF) receptor(s).
- VEGF vascular endothelial growth factor
- VEGF also referred to as vascular permeability factor (VPF) and vasculotropin
- VPF vascular permeability factor
- vasculotropin is a potent and highly specific mitogen of vascular endothelial cells (for a review see Ferrara, 1993 Trends Cardiovas. Med. 3, 244 ; Neufeld et al., 1994 Prog. Growth Factor Res. 5, 89 ).
- VEGF induced neovascularization is implicated in various pathological conditions such as tumor angiogenesis, proliferative diabetic retinopathy, hypoxia-induced angiogenesis, rheumatoid arthritis, psoriasis, wound healing and others.
- VEGF an endothelial cell-specific mitogen
- VEGF belongs to the platelet-derived growth factor (PDGF) family of growth factors with approximately 18% homology with the A and B chain of PDGF at the amino acid level. Additionally, VEGF contains the eight conserved cysteine residues common to all growth factors belonging to the PDGF family (Neufeld et al ., supra ). VEGF protein is believed to exist predominantly as disulfide-linked homodimers; monomers of VEGF have been shown to be inactive ( Plouet et al., 1989 EMBO J. 8, 3801 ).
- VEGF exerts its influence on vascular endothelial cells by binding to specific high-affinity cell surface receptors.
- Covalent cross-linking experiments with 125 I-labeled VEGF protein have led to the identification of three high molecular weight complexes of 225, 195 and 175 kDa presumed to be VEGF and VEGF receptor complexes ( Vaisman et al., 1990 J. Biol. Chem. 265, 19461 ). Based on these studies VEGF-specific receptors of 180, 150 and 130 kDa molecular mass were predicted. In endothelial cells, receptors of 150 and the 130 kDa have been identified.
- the VEGF receptors belong to the superfamily of receptor tyrosine kinases (RTKs) characterized by a conserved cytoplasmic catalytic kinase domain and a hydrophylic kinase sequence.
- RTKs receptor tyrosine kinases
- the extracellular domains of the VEGF receptors consist of seven immunoglobulin-like domains that are thought to be involved in VEGF binding functions.
- flt-1 fms-like tyrosine kinase
- KDR kinase-insert-domain-containing receptor
- VEGF expression has been associated with several pathological states such as tumor angiogenesis, several forms of blindness, rheumatoid arthritis, psoriasis and others. Following is a brief summary of evidence supporting the involvement of VEGF in various diseases:
- VEGF vascular endothelial growth factor
- Takashita et al., 1995 J. Clin. Invest. 93, 662 demonstrated that a single injection of VEGF augmented collateral vessel development in a rabbit model of ischemia.
- VEGF also can induce neovascularization when injected into the cornea.
- Expression of the VEGF gene in CHO cells is sufficient to confer tumorigenic potential to the cells.
- Kim et al ., supra and Millauer et al ., supra used monoclonal antibodies against VEGF or a dominant negative form of flk-1 receptor to inhibit tumor-induced neovascularization.
- VEGF and its receptors are associated with regions of new vascular growth ( Millauer et al., 1993 Cell 72, 835 ; Shalaby et al., 1993 J. Clin. Invest. 91, 2235 ).
- transgenic mice lacking either of the VEGF receptors are defective in blood vessel formation, infact these mouse do not survive; flk-1 appears to be required for differentiation of endothelial cells, while flt-1 appears to be required at later stages of vessel formation ( Shalaby et al., 1995 Nature 376, 62 ; Fung et al., 1995 Nature 376, 66 ).
- these receptors must be present to properly signal endothelial cells or their precursors to respond to vascularization-promoting stimuli.
- the invention features enzymatic nucleic acid molecules (ribozymes) that specifically inhibits the expression of the human flt-1 receptor and are targeted to nucleotide position 4229 of flt-1.
- ribozymes enzymatic nucleic acid molecules
- inhibit it is meant that the activity of VEGF-R or level of mRNAs or equivalent RNAs encoding VEGF-R is reduced below that observed in the absence of the nucleic acid.
- inhibition with ribozymes preferably is below that level observed in the presence of an enzymatically inactive RNA molecule that is able to bind to the same site on the mRNA, but is unable to cleave that RNA.
- inhibition with antisense oligonucleotides is preferably below that level observed in the presence of for example, an oligonucleotide with scrambled sequence or with mismatches.
- enzymatic nucleic acid molecule an RNA molecule which has complementarity in a substrate binding region to a specified gene target, and also has an enzymatic activity which is active to specifically cleave target RNA. That is, the enzymatic RNA molecule is able to intermolecularly cleave RNA and thereby inactivate a target RNA molecule. This complementary regions allow sufficient hybridization of the enzymatic RNA molecule to the target RNA and thus permit cleavage. One hundred percent complementarity is preferred, but complementarity as low as 50-75% may also be useful in this invention.
- equivalent RNA to VEGF-R is meant to include those naturally occurring RNA molecules in various animals, including human, mice, rats, rabbits, primates and pigs.
- RNA By “gene” it is meant a nucleic acid that encodes an RNA.
- complementarity it is meant a nucleic acid that can form hydrogen bond(s) with other RNA sequence by either traditional Watson-Crick or other non-traditional types (for example, Hoogsteen type) of base-paired interactions.
- enzymatic nucleic acids act by first binding to a target RNA. Such binding occurs through the target binding portion of a enzymatic nucleic acid which is held in close proximity to an enzymatic portion of the molecule that acts to cleave the target RNA.
- the enzymatic nucleic acid first recognizes and then binds a target RNA through complementary base-pairing, and once bound to the correct site, acts enzymatically to cut the target RNA. Strategic cleavage of such a target RNA will destroy its ability to direct synthesis of an encoded protein. After an enzymatic nucleic acid has bound and cleaved its RNA target, it is released from that RNA to search for another target and can repeatedly bind and cleave new targets. Thus, a single ribozyme molecule is able to cleave many molecules of target RNA.
- the ribozyme is a highly specific inhibitor of gene expression, with the specificity of inhibition depending not only on the base-pairing mechanism of binding to the target RNA, but also on the mechanism of target RNA cleavage. Single mismatches, or base-substitutions, near the site of cleavage can completely eliminate catalytic activity of a ribozyme.
- Ribozymes that cleave the specified sites in VEGF-R mRNAs represent a novel therapeutic approach to treat tumor angiogenesis, ocular diseases, rhuematoid arthritis, psoriasis and others. Applicant indicates that ribozymes are able to inhibit the activity of VEGF-R (specifically flt-1 and flk-1/KDR) and that the catalytic activity of the ribozymes is required for their inhibitory effect.
- VEGF-R specifically flt-1 and flk-1/KDR
- the enzymatic nucleic acid molecule is formed in a hammerhead or hairpin motif, but may also be formed in the motif of a hepatitis delta virus, group I intron or RNaseP RNA (in association with an RNA guide sequence) or Neurospora VS RNA.
- hammerhead motifs are described by Rossi et al., 1992, AIDS Research and Human Retroviruses 8, 183 , of hairpin motifs by Hampel et al., EP0360257 , Hampel and Tritz, 1989 Biochemistry 28, 4929 , and Hampel et al., 1990 Nucleic Acids Res.
- an enzymatic nucleic acid molecule of this invention has a specific substrate binding site which is complementary to one or more of the target gene RNA regions, and that it have nucleotide sequences within or surrounding that substrate binding site which impart an RNA cleaving activity to the molecule.
- a method for producing a class of enzymatic cleaving agents which exhibit a high degree of specificity for the RNA of a desired target.
- the enzymatic nucleic acid molecule is preferably targeted to a highly conserved sequence region of target mRNAs encoding VEGF-R proteins (specifically flt-1 and flk-1/KDR) such that specific treatment of a disease or condition can be provided with either one or several enzymatic nucleic acids.
- enzymatic nucleic acid molecules can be delivered exogenously to specific tissue or cellular targets as required.
- the ribozymes can be expressed from DNA and/or RNA vectors that are delivered to specific cells.
- nucleic acid motifs e.g ., hammerhead or the hairpin ribozymes
- the simple structure of these molecules increases the ability of the nucleic acid to invade targeted regions of the mRNA structure.
- these nucleic acid molecules can also be expressed within cells from eukaryotic promoters (e.g ., Izant and Weintraub, 1985 Science 229, 345 ; McGarry and Lindquist, 1986 Proc. Natl. Acad. Sci.
- nucleic Acids Symp USA 89, 10802-6 ; Chen et al., 1992 Nucleic Acids Res., 20, 4581-9 ; Sarver et al., 1990 Science 247, 1222-1225 ; Thompson et al., 1995 Nucleic Acids Res. 23, 2259 ).
- Those skilled in the art realize that any nucleic acid can be expressed in eukaryotic cells from the appropriate DNA/RNA vector.
- the activity of such nucleic acids can be augmented by their release from the primary transcript by a ribozyme ( Draper et al., PCT WO93/23569 , and Sullivan et al., PCT WO94/02595 ; Ohkawa et al., 1992 Nucleic Acids Symp.
- nucleic acids are useful for the prevention of the diseases and conditions discussed above, and any other diseases or conditions that are related to the levels of VEGF-R (specifically flt-1) in a cell or tissue.
- VEGF-R specifically flt-1 RNA levels and thus reduction in the level of the respective protein will relieve, to some extent, the symptoms of the disease or condition.
- Ribozymes are added directly, or can be complexed with cationic lipids, packaged within liposomes, or otherwise delivered to target cells or tissues.
- the nucleic acid or nucleic acid complexes can be locally administered to relevant tissues ex vivo, or in vivo through injection, infusion pump or stent, with or without their incorporation in biopolymers.
- the ribozymes disclosed herein have binding arms which are complementary to the sequences in Tables II to III. Examples of such ribozymes also are shown in Tables II to III. Examples of such ribozymes consist essentially of sequences defined in these Tables.
- the active ribozyme contains an enzymatic center equivalent to those in the examples, and binding arms able to bind mRNA such that cleavage at the target site occurs. Other sequences may be present which do not interfere with such cleavage.
- ribozymes that cleave target RNA molecules and inhibit VEGF-R (specifically flt-1) activity are expressed from transcription units inserted into DNA or RNA vectors.
- the recombinant vectors are preferably DNA plasmids or viral vectors. Ribozyme expressing viral vectors could be constructed based on, but not limited to, adeno-associated virus, retrovirus, adenovirus, or alphavirus.
- the recombinant vectors capable of expressing the ribozymes are delivered as described above, and persist in target cells.
- viral vectors may be used that provide for transient expression of ribozymes. Such vectors might be repeatedly administered as necessary.
- the ribozymes cleave the target mRNA. Delivery of ribozyme expressing vectors could be systemic, such as by intravenous or intramuscular administration, by administration to target cells ex-planted from the patient followed by reintroduction into the patient, or by any other means that would allow for introduction into the desired target cell.
- vectors any nucleic acid- and/or viral-based technique used to deliver a desired nucleic acid.
- Ribozymes of this invention block to some extent VEGF-R (specifically flt-1) production and can be used to treat disease or diagnose such disease. Ribozymes will be delivered to cells in culture, to cells or tissues in animal models of angiogenesis and/or RA and to human cells or tissues ex vivo or in vivo . Ribozyme cleavage of VEGF-R RNAs (specifically RNAs that encode flt-1) in these systems may alleviate disease symptoms.
- Targets for useful ribozymes can be determined as disclosed in Draper et al., International PCT Publication No. WO 95/13380 .
- Other examples include the following PCT applications which concern inactivation of expression of disease-related genes: WO 95/23225 , WO 95/13380 , WO 94/02595 . Rather than repeat the guidance provided in those documents here, below are provided specific examples of such methods, not limiting to those in the art.
- Ribozymes to such targets are designed as described in those applications and synthesized to be tested in vitro and in vivo, as also described.
- the sequence of human flt-1 mRNA was screened for optimal ribozyme target sites using a computer folding algorithm. Hammerhead or hairpin ribozyme cleavage sites were identified. These sites are shown in Tables II to III (all sequences are 5' to 3' in the tables; X can be any base-paired sequence, the actual sequence is not relevant here).
- the nucleotide base position is noted in the Tables as that site to be cleaved by the designated type of ribozyme.
- the nucleotide base position is noted in the Tables as that site to be cleaved by the designated type of ribozyme.
- ribozymes were designed that could bind and cleave target RNA in a sequence-specific manner.
- the ribozymes were individually analyzed by computer folding ( Jaeger et al., 1989 Proc. Natl. Acad. Sci. USA, 86, 7706 ) to assess whether the ribozyme sequences fold into the appropriate secondary structure. Those ribozymes with unfavorable intramolecular interactions between the binding arms and the catalytic core were eliminated from consideration. Varying binding arm lengths can be chosen to optimize activity.
- RNA is screened for accessible cleavage sites by the method described generally in Draper et al., PCT WO93/23569 . Briefly, DNA oligonucleotides complementary to potential hammerhead or hairpin ribozyme cleavage sites were synthesized. A polymerase chain reaction is used to generate substrates for T7 RNA polymerase transcription from human flt-1 cDNA clones. Labeled RNA transcripts are synthesized in vitro from the templates. The oligonucleotides and the labeled transcripts were annealed, RNAseH was added and the mixtures were incubated for the designated times at 37°C.
- RNA separation is stopped and RNA separated on sequencing polyacrylamide gels.
- the percentage of the substrate cleaved is determined by autoradiographic quantitation using a PhosphorImaging system. From these data, hammerhead or hairpin ribozyme sites are chosen as the most accessible.
- Ribozymes of the hammerhead or hairpin motif were designed to anneal to various sites in the mRNA message.
- the binding arms are complementary to the target site sequences described above.
- the ribozymes were chemically synthesized. The method of synthesis used follows the procedure for normal RNA synthesis as described in Usman et al., 1987 J. Am. Chem. Soc., 109, 7845 ; Scaringe et al., 1990 Nucleic Acids Res., 18, 5433 ; and Wincott et al., 1995 Nucleic Acids Res.
- detritylation solution was 2% TCA in methylene chloride (ABI); capping was performed with 16% N -methyl imidazole in THF (ABI) and 10% acetic anhydride/10% 2,6-lutidine in THF (ABI); oxidation solution was 16.9 mM I 2 , 49 mM pyridine, 9% water in THF (Millipore).
- B & J Synthesis Grade acetonitrile was used directly from the reagent bottle.
- E -Ethyl tetrazole solution (0.25 M in acetonitrile) was made up from the solid obtained from American International Chemical, Inc.
- RNA Deprotection of the RNA was performed as follows.
- MA methylamine
- the base-deprotected oligoribonucleotide was resuspended in anhydrous TEA•HF/NMP solution (250 ⁇ L of a solution of 1.5mL N -methylpyrrolidinone, 750 ⁇ L TEA and 1.0 mL TEA•3HF to provide a 1.4M HF concentration) and heated to 65°C for 1.5 h.
- the resulting, fully deprotected, oligomer was quenched with 50 mM TEAB (9 mL) prior to anion exchange desalting.
- the TEAB solution was loaded onto a Qiagen 500 ® anion exchange cartridge (Qiagen Inc.) that was prewashed with 50 mM TEAB (10 mL). After washing the loaded cartridge with 50 mM TEAB (10 mL), the RNA was eluted with 2 M TEAB (10 mL) and dried down to a white powder.
- Qiagen 500 ® anion exchange cartridge Qiagen Inc.
- Inactive hammerhead ribozymes were synthesized by substituting a U for G 5 and a U for A 14 (numbering from Hertel, K. J., et al., 1992, Nucleic Acids Res., 20, 3252 ).
- Hairpin ribozymes are synthesized in two parts and annealed to reconstruct the active ribozyme ( Chowrira and Burke, 1992 Nucleic Acids Res., 20, 2835-2840 ). Ribozymes are also synthesized from DNA templates using bacteriophage T7 RNA polymerase ( Milligan and Uhlenbeck, 1989, Methods Enzymol. 180, 51 ).
- ribozymes are modified extensively to enhance stability by modification with nuclease resistant groups, for example, 2'-amino, 2'- C -allyl, 2'-flouro, 2'- O -methyl, 2'-H (for a review see Usman and Cedergren, 1992 TIBS 17, 34 ; Usman et al., 1994 Nucleic Acids Symp. Ser. 31, 163 ).
- Ribozymes are purified by gel electrophoresis using general methods or are purified by high pressure liquid chromatography (HPLC; See Usman et al., PCT Publication No. WO95/23225 and are resuspended in water.
- the sequences of the ribozymes that are chemically synthesized, useful in this study, are shown in Tables II to III. Those in the art will recognize that these sequences are representative only of many more such sequences where the enzymatic portion of the ribozyme (all but the binding arms) is altered to affect activity.
- Stem-loop IV sequence of hairpin ribozymes listed in for example Table III (5'-CACGUUGUG-3') can be altered (substitution, deletion, and/or insertion) to contain any sequence, provided a minimum of two base-paired stem structure can form.
- the sequences listed in Tables II to III may be formed of ribonucleotides or other nucleotides or non-nucleotides. Such ribozymes are equivalent to the ribozymes described specifically in the Tables.
- Ribozyme activity can be optimized as described by Stinchcomb et al ., supra. The details will not be repeated here, but include altering the length of the ribozyme binding arms (stems I and III, see Figure 2c ), or chemically synthesizing ribozymes with modifications that prevent their degradation by serum ribonucleases (see e.g ., Eckstein et al., International Publication No. WO 92/07065 ; Perrault et al., 1990 Nature 344, 565 ; Pieken et al., 1991 Science 253, 314 ; Usman and Cedergren, 1992 Trends in Biochem. Sci. 17, 334 ; Usman et al ., International Publication No.
- Ribozymes may be administered to cells by a variety of methods known to those familiar to the art, including, but not restricted to, encapsulation in liposomes, by ionto-phoresis, or by incorporation into other vehicles, such as hydrogels, cyclodextrins, biodegradable nanocapsules, and bioadhesive microspheres.
- ribozymes may be directly delivered ex vivo to cells or tissues with or without the aforementioned vehicles.
- the RNA/vehicle combination is locally delivered by direct injection or by use of a catheter, infusion pump or stent.
- routes of delivery include, but are not limited to, intravascular, intramuscular, subcutaneous or joint injection, aerosol inhalation, oral (tablet or pill form), topical, systemic, ocular, intraperitoneal and/or intrathecal delivery. More detailed descriptions of ribozyme delivery and administration are provided in Sullivan et al ., supra and Draper et al., supra .
- RNA polymerase I RNA polymerase I
- RNA polymerase II RNA polymerase II
- RNA polymerase III RNA polymerase III
- Transcripts from pol II or pol III promoters will be expressed at high levels in all cells; the levels of a given pol II promoter in a given cell type will depend on the nature of the gene regulatory sequences (enhancers, silencers, etc.) present nearby.
- Prokazyotic RNA polymerase promoters are also used, providing that the prokaryotic RNA polymerase enzyme is expressed in the appropriate cells ( Elroy-Stein and Moss, 1990 Proc. Natl. Acad. Sci. U S A, 87, 6743-7 ; Gao and Huang 1993 Nucleic Acids Res., 21, 2867-72 ; Lieber et al., 1993 Methods Enzymol., 217, 47-66 ; Zhou et al., 1990 Mol. Cell. Biol., 10, 4529-37 ; Thompson et al ., 1995 supra ).
- ribozymes expressed from such promoters can function in mammalian cells ( e.g .
- ribozyme transcription units can be incorporated into a variety of vectors for introduction into mammalian cells, including but not restricted to, plasmid DNA vectors, viral DNA vectors (such as adenovirus or adeno-associated virus vectors), or viral RNA vectors (such as retroviral or alphavirus vectors).
- plasmid DNA vectors such as adenovirus or adeno-associated virus vectors
- viral RNA vectors such as retroviral or alphavirus vectors
- RNAs that encode flt-1, KDR and/or flk-1 that is inserted into a plasmid DNA vector or an adenovirus or adeno-associated virus DNA viral vector or a retroviral RNA vector.
- Viral vectors have been used to transfer genes and lead to either transient or long term gene expression ( Zabner et al., 1993 Cell 75, 207 ; Carter, 1992 Curr. Opi. Biotech. 3, 533 ).
- the adenovirus, AAV or retroviral vector is delivered as recombinant viral particles.
- the DNA may be delivered alone or complexed with vehicles (as described for RNA above).
- the recombinant adenovirus or AAV or retroviral particles are locally administered to the site of treatment, e.g ., through incubation or inhalation in vivo or by direct application to cells or tissues ex vivo .
- Retroviral vectors have also been used to express ribozymes in mammalian cells (Ojwang et al ., 1992 supra; Thompson et al ., 1995 supra ).
- flt-1, KDR and/or flk-1 are attractive nucleic acid-based therapeutic targets by several criteria.
- the interaction between VEGF and VEGF-R is well-established. Efficacy can be tested in well-defined and predictive animal models. Finally, the disease conditions are serious and current therapies are inadequate. Whereas protein-based therapies would inhibit VEGF activity nucleic acid-based therapy provides a direct and elegant approach to directly modulate flt-1, KDR and/or flk-1 expression.
- flt-1 and KDR mRNAs are highly homologous in certain regions, some ribozyme target sites are also homologous (see Table IV).
- a single ribozyme will target both flt-1 and KDR mRNAs.
- a single ribozyme can sometimes be designed to accomodate a site on both mRNAs by including G/U basepairing. For example, if there is a G present in a ribozyme target site in KDR mRNA at the same position there is an A in the flt-1 ribozyme target site, the ribozyme can be synthesized with a U at the complementary position and it will bind both to sites.
- the advantage of one ribozyme that targets both VEGF-R mRNAs is clear, especially in cases where both VEGF receptors may contribute to the progression of angiogenesis in the disease state.
- Angiogenesis refers to formation of new blood vessels which is an essential process in reproduction, development and wound repair.
- Tumor angiogenesis refers to the induction of the growth of blood vessels from surrounding tissue into a solid tumor. Tumor growth and tumor metastasis are dependent on angiogenesis (for a review see Folkman, 1985 supra ; Folkman 1990 J. Natl. Cancer Inst., 82, 4 ; Folkman and Shing, 1992 J. Biol. Chem. 267, 10931 ).
- Angiogenesis plays an important role in other diseases such as arthritis wherein new blood vessels have been shown to invade the joints and degrade cartilage (Folkman and Shing, supra ).
- Retinopathy refers to inflammation of the retina and/or degenerative condition of the retina which may lead to occlusion of the retina and eventual blindness.
- angiogenesis causes the capillaries in the retina to invade the vitreous resulting in bleeding and blindness which is also seen in neonatal retinopathy (for a review see Folkman, 1985 supra ; Folkman 1990 supra ; Folkman and Shing, 1992 supra).
- Example 1 flt-1, KDR and/or flk-1 ribozymes
- ribozyme motifs By engineering ribozyme motifs applicant has designed several ribozymes directed against flt-1, KDR and/or flk-1 encoded mRNA sequences. These ribozymes were synthesized with modifications that improve their nuclease resistance ( Beigelman et al., 1995 J Biol. Chem. 270, 25702 ) and enhance their activity in cells. The ability of ribozymes to cleave target sequences in vitro was evaluated essentially as described in Thompson et al., PCT Publication No. WO 93/23057 ; Draper et al., PCT Publication No. WO 95/04818 .
- flt-1, KDR and/or flk-1 can be detected easily with monoclonal antibodies.
- FACS fluorescence-activated cell-sorting
- Active ribozymes are expected to directly reduce flt-1, KDR and/or flk-1 expression and thereby reduce VEGF binding to the cells.
- human umbelical cord microvascular endothelial cells were used.
- Plates are coated with 1.5% gelatin and allowed to stand for one hour.
- Cells e.g., microvascular endothelial cells derived from human umbilical cord vein
- 20,000 cells/well 24 well plate
- 200 ml growth media 200 ml
- cells 75-80% confluent
- the assay is carried out on ice to inhibit internalization of VEGF during the experiment.
- the media containing the ribozyme is removed from the cells and the cells are washed twice with with 300 ml 1X PBS : Ca 2+ : Mg 2+ mixture containing 1% BSA.
- Appropriate 125 I VEGF solution (100,000 cpm/well, +/- 10 X cold 1X PBS, 1% BSA) was applied to the cells.
- the cells are incubated on ice for 1 h.
- 125 I VEGF-containing solution is removed and the cells are washed three times with with 300 ml 1X PBS: Ca 2+ : Mg 2+ mixture containing 1% BSA.
- Hammerhead ribozymes targeted to twenty sites within flt-1 RNA were synthesized as described above. Sequence of the ribozymes used are shown in Table II; the length of stem II region is 3 bp.
- the hammerhead ribozymes were chemically modified such that the ribozyme consists of ribose residues at five positions; U4 and U7 positions contain 2'-NH 2 modifications, the remaining nucleotide positions contain 2'- O -methyl substitutions; four nucleotides at the 5' terminus contains phosphorothioate substitutions. Additionally, 3' end of the ribozyme contains a 3'-3' linked inverted abasic ribose.
- anti-flt-1 ribozymes specifically cleave flt-1 RNA and not RNAs encoding the receptors for UPA and FGF, resulting in the inhibition of flt-1 receptor expression on the surface of the cells.
- the ribozymes are responsible for the inhibition of VEGF binding but not the binding of UPA and FGF.
- 24-well plates are coated with 1.5% gelatin (porcine skin 300 bloom). After 1 hr, excess gelatin is washed off of the plate.
- Microvascular endothelial cells are plated at 5,000 cells/well (24 well plate) in 200 ml growth media. The cells are allowed to grow for - 18 hr (- 1 doubling) to yield -10,000 cells (25-30% confluent).
- the media is removed from the cells and the cells are washed with 300 ml 1X PBS: Ca 2- : Mg 2+ mixture.
- Maintenance media (contains dialyzed 10% FBS) +/- VEGF or basic FGF at 10 ng/ml is added to the cells.
- the cells are incubated for 48 or 72 h.
- the cells are trypsinized and counted (Coulter counter). Trypan blue is added on one well of each treatment as control.
- VEGF and basic FGF can stimulate human microvascular endothelial cell proliferation.
- treatment of cells with 1358 HH or 4229 HH ribozymes, targeted against flt-1 mRNA results in a significant decrease in the ability of VEGF to stimulate endothelial cell proliferation.
- These ribozymes do not inhibit the FGF-mediated stimulation of endothelial cell proliferation.
- hammerhead ribozymes targeted against sites 1358 and 4229 within the flt-1 RNA were synthesized as described above.
- Substrate RNA was 5' end-labeled using [g- 32 P] ATP and T4 polynucleotide kinase (US Biochemicals). Cleavage reactions were carried out under ribozyme "excess" conditions. Trace amount (s 1 nM) of 5' end-labeled substrate and 40 nM unlabeled ribozyme were denatured and renatured separately by heating to 90°C for 2 min and snap-cooling on ice for 10-15 min. The ribozyme and substrate were incubated, separately, at 37°C for 10 min in a buffer containing 50 mM Tris-HCl and 10 mM MgCl 2 .
- the reaction was initiated by mixing the ribozyme and substrate solutions and incubating at 37°C. Aliquots of 5 ml are taken at regular intervals of time and the reaction is quenched by mixing with equal volume of 2X formamide stop mix. The samples are resolved on 20 % denaturing polyacrylamide gels. The results were quantified and percentage of target RNA cleaved is plotted as a function of time.
- hammerhead ribozymes targeted against sites 1358 and 4229 within the flt-1 RNA are capable of cleaving target RNA efficiently in vitro.
- Example 6 In vitro cleavage of RNA by hammerhead ribozymes targeted against cleavage sites that are homologous between KDR and flt-1 mRNA
- flt-1 and KDR mRNAs are highly homologous in certain regions, some ribozyme target sites are also homologous (see Table X). In this case, a single ribozyme will target both flt-1 and KDR mRNAs.
- Hammerhead ribozyme (FLT/KDR-I) targeted against one of the homologous sites between flt-1 and KDR (flt-1 site 3388 and KDR site 3151) was synthesized as described above.
- Ribozymes with either a 3 bp stem II or a 4 bp stem II were synthesized. RNA cleavage reactions were carried out in vitro essentially as described under Example 5.
- FLT/KDR-I ribozyme with either a 3 or a 4 bp stem II was able to cleave its target RNA efficiently in vitro.
- flt-1 and KDR receptors of VEGF are involved in angiogenesis, the inhibition of the expression of both of these genes may be an effective approach to inhibit angiogenesis.
- VEGF-R mRNAs there are several animal models in which the anti-angiogenesis effect of nucleic acids of the present invention, such as ribozymes, directed against VEGF-R mRNAs can be tested.
- a corneal model has been used to study angiogenesis in rat and rabbit since recruitment of vessels can easily be followed in this normally avascular tissue ( Pandey et al., 1995 Science 268: 567-569 ).
- angiogenesis factor e.g. bFGF or VEGF
- Ribozymes directed against VEGF-R mRNAs would be delivered in the disk as well, or dropwise to the eye over the time course of the experiment.
- hypoxia has been shown to cause both increased expression of VEGF and neovascularization in the retina ( Pierce et al., 1995 Proc. Natl. Acad. Sci. USA. 92: 905-909 ; Shweiki et al., 1992 J. Clin. Invest. 91: 2235-2243 ).
- VEGF is at least partially responsible for tumor angiogenesis ( Plate et al., 1992 Nature 359, 845 ).
- Animal models have been developed in which glioblastoma cells are implanted subcutaneously into nude mice and the progress of tumor growth and angiogenesism is studied (Kim et al ., 1993 supra ; Millauer et al ., 1994 supra ).
- Matrigel an extract of basement membrane that becomes a solid gel when injected subcutaneously ( Passaniti et al., 1992 Lab. Invest. 67: 519-528 ).
- angiogenesis factors such as VEGF
- vessels grow into the Matrigel over a period of 3 to 5 days and angiogenesis can be assessed.
- ribozymes directed against VEGF-R mRNAs would be delivered in the Matrigel.
- corneal vessel formation following corneal injury ( Burger et al., 1985 Cornea 4: 35-41 ; Lepri, et al., 1994 J. Ocular Pharmacol. 10: 273-280 ; Ormerod et al., 1990 Am. J. Pathol. 137: 1243-1252 ) or intracorneal growth factor implant ( Grant et al., 1993 Diabetologia 36: 282-291 ; Pandey et al . 1995 supra; Zieche et al., 1992 Lab. Invest.
- the cornea model is the most common and well characterized anti-angiogenic agent efficacy screening model.
- This model involves an avascular tissue into which vessels are recruited by a stimulating agent (growth factor, thermal or alkalai burn, endotoxin).
- the corneal model would utilize the intra-stromal corneal implantation of a Teflon pellet soaked in a VEGF-Hydron solution to recruit blood vessels toward the pellet which can be quantitated using standard microscopic and image analysis techniques.
- ribozymes are applied topically to the eye or bound within Hydron on the Teflon pellet itself.
- This avascular cornea as well as the Matrigel provide for low background assays. While the corneal model has been performed extensively in the rabbit, studies in the rat have also been conducted.
- the mouse model (Passaniti et al., supra ) is a non-tissue model which utilizes Matrigel, an extract of basement membrane (Kleinman et al., 1986) or Millipore ® filter disk, which can be impregnated with growth factors and anti-angiogenic agents in a liquid form prior to injection.
- the Matrigel or Millipore ® filter disk forms a solid implant.
- VEGF embedded in the Matrigel or Millipore ® filter disk would be used to recruit vessels within the matrix of the Matrigel or Millipore ® filter disk which can be processed histologically for endothelial cell specific vWF (factor VIII antigen) immunohistochemistry, Trichrome-Masson stain, or hemoglobin content.
- vWF factor VIII antigen
- the Matrigel or Millipore ® filter disk are avascular; however, it is not tissue.
- ribozymes are administered within the matrix of the Matrigel or Millipore ® filter disk to test their anti-angiogenic efficacy.
- delivery issues in this model as with delivery of ribozymes by Hydron-coated Teflon pellets in the rat cornea model, may be less problematic due to the homogeneous presence of the ribozyme within the respective matrix.
- VEGF vascular endothelial growth factor
- ribozymes will target only VEGFr mRNA.
- the involvement of other non-specific types of stimuli in the cornea and Matrigel models is not advantageous from the standpoint of understanding the pharmacologic mechanism by which the anti-VEGFr mRNA ribozymes produce their effects.
- the models will allow for testing the specificity of the anti-VEGFr mRNA ribozymes by using either a- or bFGF as a pro-angiogenic factor. Vessel recruitment using FGF should not be affected in either model by anti-VEGFr mRNA ribozymes.
- flt-1, KDR and/or flk-1 protein levels can be measured clinically or experimentally by FACS analysis flt-1, KDR and/or flk-1 encoded mRNA levels will be assessed by Northern analysis, RNase-protection, primer extension analysis and/or quantitative RT-PCR. Ribozymes that block flt-1, KDR and/or flk-1 protein encoding mRNAs and therefore result in decreased levels of flt-1, KDR and/or flk-1 activity by more than 20% in vitro will be identified.
- Ribozymes and/or genes encoding them are delivered by either free delivery, liposome delivery, cationic lipid delivery, adeno-associated virus vector delivery, adenovirus vector delivery, retrovirus vector delivery or plasmid vector delivery in these animal model experiments (see above).
- Patients can be treated by locally administering nucleic acids targeted against VEGF-R by direct injection.
- Routes of administration may include, but are not limited to, intravascular, intramuscular, subcutaneous, intra-articular, aerosol inhalation, oral (tablet, capsule or pill form), topical, systemic, ocular, intraperitoneal and/or intrathecal delivery.
- ribozymes targeted against flt-1 4229 site in the rat cornea model of VEGF induced angiogenesis (see above).
- These ribozymes have either active or inactive catalytic core and either bind and cleave or just bind to VEGF-R mRNA of the flt-1 subtype.
- the active ribozymes that are able to bind and cleave the target RNA, have been shown to inhibit ( 125 I-labeled) VEGF binding in cultured endothelial cells and produce a dose-dependent decrease in VEGF induced endothelial cell proliferation in these cells (see Examples 3-4 above).
- the catalytically inactive forms of these ribozymes wherein the ribozymes can only bind to the RNA but cannot catalyze RNA cleavage, fail to show these characteristics.
- the ribozymes and VEGF were co-delivered using the filter disk method: Nitrocellulose filter disks (Millipore ® ) of 0.057 diameter were immersed in appropriate solutions and were surgically implanted in rat cornea as described by Pandey et al ., supra . This delivery method has been shown to deliver rhodamine-labeled free ribozyme to scleral cells and, in all likelihood cells of the pericorneal vascular plexus. Since the active ribozymes show cell culture efficacy and can be delivered to the target site using the disk method, it is essential that these ribozymes be assessed for in vivo anti-angiogenic activity.
- the stimulus for angiogenesis in this study was the treatment of the filter disk with 30 mM VEGF which is implanted within the cornea's stroma. This dose yields reproducible neovascularization stemming from the pericorneal vascular plexus growing toward the disk in a dose-response study 5 days following implant. Filter disks treated only with the vehicle for VEGF show no angiogenic response.
- the ribozymes was co-adminstered with VEGF on a disk in two different ribozyme concentrations. One concern with the simultaneous administration is that the ribozymes will not be able to inhibit angiogenesis since VEGF receptors can be stimulated.
- VEGF and RIBOZYMES were prepared as a 2X solution for 1:1 mixing for final concentrations above, with the exception of solution 1 in which VEGF was 2X and diluted with ribozyme diluent (sterile water).
- the 2X VEGF solution (60 ⁇ M) was prepared from a stock of 0.82 ⁇ g/ ⁇ L in 50 mM Tris base. 200 ⁇ L of VEGF stock was concentrated by speed vac to a final volume of 60.8 ⁇ L, for a final concentration of 2.7 ⁇ g/ ⁇ L or 60 ⁇ M. Six 10 ⁇ L aliquots was prepared for daily mixing. 2X solutions for VEGF and Ribozyme was stored at 4°C until the day of the surgery. Solutions were mixed for each day of surgery. Original 2X solutions was prepared on the day before the first day of the surgery.
- the animal cornea were treated with the treatment groups as described above. Animals were allowed to recover for 5 days after treatment with daily observation (scoring 0 - 3). On the fifth day animals were euthanized and digital images of each eye was obtained for quantitaion using Image Pro Plus. Quantitated neovascular surface area were analyzed by ANOVA followed by two post-hoc tests including Dunnets and Tukey-Kramer tests for significance at the 95% confidence level. Dunnets provide information on the significance between the differences within the means of treatments vs. controls while Tukey-Kramer provide information on the significance of differences within the means of each group.
- Results are graphically represented in Figure 13 .
- flt-1 4229 active hammerhead ribozyme at both concentrations was effective at inhibiting angiogenesis while the inactive ribozyme did not show any significant reduction in angiogenesis.
- a statistically signifying reduction in neovascular surface area was observed only with active ribozymes.
- This result clearly shows that the ribozymes are capable of significantly inhibiting angiogenesis in vivo. Specifically, the mechanism of inhibition appears to be by the binding and cleavage of target RNA by ribozymes.
- the ribozymes disclosed herein may be used as diagnostic tools to examine genetic drift and mutations within diseased cells or to detect the presence of flt-1, KDR and/or flk-1 RNA in a cell.
- the close relationship between ribozyme activity and the structure of the target RNA allows the detection of mutations in any region of the molecule which alters the base-pairing and three-dimensional structure of the target RNA.
- By using multiple ribozymes disclosed herein one may map nucleotide changes which are important to RNA structure and function in vitro, as well as in cells and tissues. Cleavage of target RNAs with ribozymes may be used to inhibit gene expression and define the role (essentially) of specified gene products in the progression of disease.
- ribozymes targeted to different genes, ribozymes coupled with known small molecule inhibitors, or intermittent treatment with combinations of ribozymes and/or other chemical or biological molecules.
- Other in vitro uses of ribozymes disclosed herein are well known in the art, and include detection of the presence of mRNAs associated with flt-1, KDR and/or flk-1 related condition. Such RNA is detected by determining the presence of a cleavage product after treatment with a ribozyme using standard methodology.
- ribozymes which can cleave only wild-type or mutant forms of the target RNA are used for the assay.
- the first ribozyme is used to identify wild-type RNA present in the sample and the second ribozyme will be used to identify mutant RNA in the sample.
- synthetic substrates of both wild-type and mutant RNA will be cleaved by both ribozymes to demonstrate the relative ribozyme efficiencies in the reactions and the absence of cleavage of the "non-targeted" RNA species.
- the cleavage products from the synthetic substrates will also serve to generate size markers for the analysis of wild-type and mutant RNAs in the sample population.
- each analysis will require two ribozymes, two substrates and one unknown sample which will be combined into six reactions.
- the presence of cleavage products will be determined using an RNAse protection assay so that full-length and cleavage fragments of each RNA can be analyzed in one lane of a polyacrylamide gel. It is not absolutely required to quantify the results to gain insight into the expression of mutant RNAs and putative risk of the desired phenotypic changes in target cells.
- the expression of mRNA whose protein product is implicated in the development of the phenotype i.e., flt-1, KDR and/or flk-1) is adequate to establish risk.
- RNA levels will be adequate and will decrease the cost of the initial diagnosis. Higher mutant form to wild-type ratios will be correlated with higher risk whether RNA levels are compared qualitatively or quantitatively.
- RNAseP RNA M1 RNA
- RNA portion of a ribonucleoprotein enzyme Cleaves tRNA precursors to form mature tRNA.
- HDV Hepatitis Delta Virus
- the length of stem II may be ⁇ 2 base-pairs.
- Table III Human flt 1 VEGF Receptor-Hairpin Ribozyme and Substrate Sequence nt. Position HP Ribozyme Sequence Substrate 16 CGGGGAGG AGAA GAGAGG ACCAGAGAAACACACGUUGUGGUACAUUACCUGGUA CCUCUCG GCU CCUCCCCG 39 CCGCUCCG AGAA GCCGCC ACCAGAGAAACACACGUUGUGGUACAUUACCUGGUA GGCGGCG GCU CGGAGCGG 180 CCGCCAGA AGAA GUCCUC ACCAGAGAAACACACGUUGUGGUACAUUACCUGGUA GAGGACG GAC UCUGGCGG 190 AACGACCC AGAA GCCAGA ACCAGAGAAACACACGUUGUGGUACAUUACCUGGUA UCUGGCG GCC GGGUCGUU 278 GCGCAC AGAA GGACCC ACCAGAGAAAA
- Position flt-1 Target Sequence nt. Position KDR Target Sequence 3388 CCGGGAU A UUUAUAA 3151 CCGGGAU A UUUAUAA 2174 AAUGUAU A CACAGGG 3069 AgUGUAU c CACAGGG 2990 UGCAAAU A UGGAAAU 2756 UGCAAAU u UGGAAAc 2693 CUCCCUU A UGAUGCC 2459 CUgCCUU A UGAUGCC 2981 GUUGAAU A CUGCAAA 2747 GUgGAAU u CUGCAAA 1359 UAUGGUU A AAAGAUG 2097 UgUGGUU u AAAGAUa 3390 GGGAUAU U UAUAAGA 3153 GGGAUAU U UAUAAag 3391 GGAUAUU U AUAAGAA 3154 GGAUAUU U AUAAagA 2925 ACGUGGU U AACCUGC 2691 AUGUGGU c AACCUuC 7140 UAUUUCU A GUCAUGA 2340 UAc
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Claims (10)
- Ein Nukleinsäuremolekül, das spezifisch die Expression einer mRNA inhibiert, kodierend für den flt-1-Rezeptor des menschlichen vaskulären endothelialen Wachstumsfaktors, wobei das Nukleinsäuremolekül ein enzymatisches Nukleinsäuremolekül ist, das auf die Nukleotid-Position 4229 des flt-1 gerichtet ist.
- Das Nukleinsäuremolekül gemäß Anspruch 1, wobei das Nukleinsäuremolekül 16 Basen umfasst, die komplementär zur RNA sind, kodierend für den flt-1-Rezeptor.
- Das Nukleinsäuremolekül gemäß Anspruch 1 oder 2, wobei das Nukleinsäuremolekül sich in einem Hammerhead-, Haarnadel-, Hepatitis-Delta-Virus-, Gruppe-I-Intron-, VS-Nukleinsäure- oder RNase-P-Nukleinsäure-Motiv befindet.
- Das Nukleinsäuremolekül gemäß Anspruch 3, wobei das Nukleinsäuremolekül sich in einem Hammerhead-Nukleinsäuremotiv befindet.
- Das Nukleinsäuremolekül gemäß Anspruch 4, wobei das enzymatische Nukleinsäuremolekül Bindungsarme umfasst, die Sequenz enthalten, die komplementär zu einer Substrat-Nukleotid-Basensequenz CCCAGACUAC AACUCGG (SEQ.-ID.Nr.: 2130) ist.
- Ein In-vitro-Verfahren zur Spaltung von RNA des flt-1-Gens, umfassend den Schritt des Inkontaktbringens der RNA mit dem enzymatischen Nukleinsäuremolekül gemäß Anspruch 4 oder 5 unter Bedingungen, die zur Spaltung der RNA geeignet sind.
- Ein Expressionsvektor, umfassend eine Nukleinsäuresequenz, die für das Nukleinsäuremolekül gemäß Anspruch 1 kodiert.
- Eine isolierte Säugerzelle, umfassend ein Nukleinsäuremolekül gemäß Anspruch 1 oder einen Expressionsvektor gemäß Anspruch 7.
- Die Säugerzelle gemäß Anspruch 8, wobei die Säugerzelle eine menschliche Zelle ist.
- Verwendung des Nukleinsäuremoleküls gemäß Anspruch 1 zur Herstellung eines Medikaments zur Behandlung eines Erkrankungszustandes, ausgewählt aus der Gruppe, bestehend aus Tumorangiogenese, Augenerkrankungen, Psoriasis und rheumatoider Arthritis, wobei der Zustand mit dem Grad der flt-1-Aktivität verbunden ist.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US597495P | 1995-10-26 | 1995-10-26 | |
| US5974P | 1995-10-26 | ||
| US08/584,040 US6346398B1 (en) | 1995-10-26 | 1996-01-11 | Method and reagent for the treatment of diseases or conditions related to levels of vascular endothelial growth factor receptor |
| US584040 | 1996-01-11 | ||
| EP96939515A EP0859837A2 (de) | 1995-10-26 | 1996-10-25 | Verfahren und reagenz zur behandlung von krankheiten die von der konzentration der rezeptors für den wachstumsfaktor der vaskulären endothelzellen, verursacht werden |
Related Parent Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP96939515A Division EP0859837A2 (de) | 1995-10-26 | 1996-10-25 | Verfahren und reagenz zur behandlung von krankheiten die von der konzentration der rezeptors für den wachstumsfaktor der vaskulären endothelzellen, verursacht werden |
| EP96939515.1 Division | 1997-05-01 |
Publications (3)
| Publication Number | Publication Date |
|---|---|
| EP1408111A2 EP1408111A2 (de) | 2004-04-14 |
| EP1408111A3 EP1408111A3 (de) | 2004-09-08 |
| EP1408111B1 true EP1408111B1 (de) | 2010-06-09 |
Family
ID=32033890
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP04000536A Expired - Lifetime EP1408111B1 (de) | 1995-10-26 | 1996-10-25 | Verfahren und Reagenz zur Behandlung von Krankheiten die von der Konzentration des Rezeptors für den Wachstumsfaktor der vaskulären Endothelzellen verursacht werden |
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| Country | Link |
|---|---|
| EP (1) | EP1408111B1 (de) |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA2135499A1 (en) | 1992-05-14 | 1993-11-25 | James D. Thompson | Method and reagent for inhibiting cancer development |
| CN1701814A (zh) * | 1992-11-13 | 2005-11-30 | 马克斯普朗克科学促进协会 | 作为血管内皮生长因子受体的f1k-1 |
| WO1994021791A1 (en) * | 1993-03-16 | 1994-09-29 | Johanna Eugenie Bergmann | Agents for the prevention and treatment of breast cancer |
| WO1995004818A1 (en) | 1993-08-06 | 1995-02-16 | Ribozyme Pharmaceuticals, Inc. | Method and reagent for inhibiting human immunodeficiency virus replication |
| ATE226254T1 (de) * | 1993-11-12 | 2002-11-15 | Ribozyme Pharm Inc | Reagenz zur behandlung von arthritischen zustaenden |
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- 1996-10-25 EP EP04000536A patent/EP1408111B1/de not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| EP1408111A3 (de) | 2004-09-08 |
| EP1408111A2 (de) | 2004-04-14 |
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